Gastroenterology
Volume 138, Issue 1 , Pages 30-33 , January 2010

Reducing the Gastrointestinal Risks of Low-Dose Aspirin

  • Byron Cryer

      Affiliations

    • Corresponding Author InformationReprint requests Address requests for reprints to: Byron Cryer, MD, Department of Medicine, Division of Digestive Diseases, Dallas VA Medical Center, University of Texas Southwestern Medical School, 4500 S Lancaster Rd. (111B1), Dallas, TX 75216

References 

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  3. Bhatt DL, Scheiman J, Abraham NS, et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. Am J Gastroenterol. 2008;103:2890–2907
  4. Weil J, Colin-Jones D, Langman M, et al. Prophylactic aspirin and risk of peptic ulcer bleeding. BMJ. 1995;310:827–830
  5. McQuaid K, Laine L. Systematic review and meta-analysis of adverse events of low-dose aspirin and clopidogrel in randomized controlled trials. Am J Med. 2006;119:624–638
  6. Cryer B, Feldman M. Effects of very low dose daily, long-term aspirin therapy on gastric, duodenal, and rectal prostaglandin levels and on mucosal injury in healthy humans. Gastroenterology. 1999;117:17–25
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  9. Cryer B. Mucosal defense and repair (Role of prostaglandins in the stomach and duodenum). Gastroenterol Clin North Am. 2001;30:877–894
  10. Davenport HW. Damage to the gastric mucosa: effects of salicylates and stimulation. Gastroenterology. 1965;49:189–196
  11. Lichtenberger LM, Zhou Y, Dial EJ, et al. NSAID injury to the gastrointestinal tract: evidence that NSAIDs interact with phospholipids to weaken the hydrophobic surface barrier and induce the formation of unstable pores in membranes. J Pharm Pharmacol. 2006;58:1421–1428
  12. Chan FKL, Chung SC, Yuen BY, et al. Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen. N Engl J Med. 2001;344:967–973
  13. Yeomans N, Lanas A, Labenz J, et al. Efficacy of esomeprazole (20 mg once daily) for reducing the risk of gastroduodenal ulcers associated with continuous use of low-dose aspirin. Am J Gastroenterol. 2008;103:2465–2473
  14. Taha AS, McCloskey C, Prasad R, et al. Famotidine for the prevention of peptic ulcers and oesophagitis in patients taking low-dose aspirin (FAMOUS): a phase III, randomised, double-blind, placebo-controlled trial. Lancet. 2009;374:119–125
  15. Richter JE. Gastroesophageal reflux disease and its complications. In:  Feldman M, et al. editor. Sleisenger and Fordtran's gastrointestinal and liver disease. 8th ed.. Philadelphia: Saunders Elsevier; 2006;p. 905–936Vol. 1
  16. Graham DY, Agrawal NM, Campbell DR, et al. Ulcer prevention in long-term users of nonsteroidal anti-inflammatory drugs: results of a double-blind, randomized, multicenter, active- and placebo-controlled study of misoprostol vs. lansoprazole. Arch Intern Med. 2002;162:169–175
  17. Scheiman JM, Yeomans ND, Talley NJ, et al. Prevention of ulcers by esomeprazole in at-risk patients using non-selective NSAIDs and COX-2 inhibitors. Am J Gastroenterol. 2006;101:701–710
  18. Yeomans ND, Tulassay Z, Juhasz L, et al. Omeprazole compared with ranitidine for ulcers associated with nonsteroidal antiinflammatory drugs. N Engl J Med. 1998;338:719–726
  19. Ng F–H, Wong S–Y, Lam K–F, et al. Famotidine is inferior to pantoprazole in preventing recurrence of aspirin-related peptic ulcers or erosions. Gastroenterology. 2010;138:82–88
  20. Graham DY. Endoscopic ulcers are neither meaningful nor validated as a surrogate for clinically significant upper gastrointestinal harm. Clin Gastroenterol Hepatol. 2009;7:1147–1150
  21. Moore A, Bjarnason I, Cryer B, et al. Evidence for endoscopic ulcers as meaningful surrogate endpoint for clinically significant upper gastrointestinal harm. Clin Gastroenterol Hepatol. 2009;7:1156–1163
  22. Tramer MR, Moore RA, Reynolds DJ, et al. Quantitative estimation of rare adverse events which follow a biological progression: a new model applied to chronic NSAID use. Pain. 2000;85:169–182
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  24. Lanas A, Garcia-Rodriguez LA, Arroyo MT, et al. Effect of antisecretory drugs and nitrates on the risk of ulcer bleeding associated with nonsteroidal anti-inflammatory drugs, antiplatelet agents, and anticoagulants. Am J Gastroenterol. 2007;102:507–515

 Conflicts of interest The author discloses the following: he has current consulting relationships with AstraZeneca, Inc, Horizon Therapeutics, McNeil Consumer Products, NiCox Inc, PLx Pharma, Pfizer Inc. and POZEN, Inc. and that he has received current research grants from PLx Pharma and Pfizer Inc.

PII: S0016-5085(09)02049-6

doi: 10.1053/j.gastro.2009.11.032

Gastroenterology
Volume 138, Issue 1 , Pages 30-33 , January 2010

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